Percutaneous Instrument with Collet Locking Mechanisms

ABSTRACT

A surgical device comprises an elongate shaft comprising an outer tube and an inner rod positioned in the outer tube, the outer tube and inner rod each comprising a distal end and a proximal end. An actuator is operably connected to the proximal ends of the outer tube and the inner rod. An end effector is adapted for in vivo attachment to and detachment from the distal ends of the outer tube and the inner rod, the end effector comprising a collet for locking engagement with the distal end of the inner rod. The end effector may further comprise a second collet for locking engagement with the outer tube. The surgical device may further comprise a loader comprising a collet for locking the end effector in the loader.

BACKGROUND

The present invention relates in general to surgical devices andprocedures, and more particularly to minimally invasive surgery.

Surgical procedures are often used to treat and cure a wide range ofdiseases, conditions, and injuries. Surgery often requires access tointernal tissue through open surgical procedures or endoscopic surgicalprocedures. The term “endoscopic” refers to all types of minimallyinvasive surgical procedures including laparoscopic, arthroscopic,natural orifice intraluminal, and natural orifice transluminalprocedures. Endoscopic surgery has numerous advantages compared totraditional open surgical procedures, including reduced trauma, fasterrecovery, reduced risk of infection, and reduced scarring. Endoscopicsurgery is often performed with an insufflatory fluid present within thebody cavity, such as carbon dioxide or saline, to provide adequate spaceto perform the intended surgical procedures. The insufflated cavity isgenerally under pressure and is sometimes referred to as being in astate of pneumoperitoneum. Surgical access devices are often used tofacilitate surgical manipulation of internal tissue while maintainingpneumoperitoneum. For example, trocars are often used to provide a portthrough which endoscopic surgical instruments are passed. Trocarsgenerally have an instrument seal, which prevents the insufflatory fluidfrom escaping while an instrument is positioned in the trocar.

While a variety of different minimally invasive surgical devices areknown, no one has previously made or used the surgical devices andmethods in accordance with the present invention.

SUMMARY

In one embodiment a surgical device comprises an elongate shaftcomprising a distal end and a proximal end. An actuator is operablyconnected to the proximal end of the elongate shaft. An end effector isadapted for attachment to and detachment from the distal end of theelongate shaft. The end effector comprises a laterally deflecting armdimensioned to engage at least a portion of the distal end of theelongate shaft and a ring comprising a first axial position and a secondaxial position, wherein in the first position the arm can deflectlaterally and in the second position the ring circumscribes the arm andconstrains the arm from deflecting laterally.

The distal end of the inner rod may comprise a pointed tip. The actuatormay comprise a manual handle. The end effector may be adapted for invivo attachment and detachment from the distal end of the elongateshaft. The elongate shaft may be adapted for direct percutaneousinsertion. The surgical device may further comprise a spring in the endeffector biasing the ring to the second position. The ring firstposition may be is distal of the ring second position. The surgicaldevice may further comprise a loader dimensioned for receiving endeffector. The loader may comprise a locked state where the end effectoris locked in the loader and the end effector ring is in its firstposition, and an unlocked state where the end effector is unlocked fromthe loader and the end effector ring is in its second position. The armmay comprise a medial tooth that engages a groove in the distal end ofthe elongate shaft.

In another embodiment, a surgical device comprises an elongate shaftcomprising an outer tube and an inner rod positioned in the outer tube.The outer tube and inner rod each comprise a distal end and a proximalend. The inner rod and outer tube each comprise a groove on the distalend. An actuator is operably connected to the proximal ends of the outertube and the inner rod. An end effector is adapted for in vivoattachment to and detachment from the distal ends of the outer tube andthe inner rod. The end effector comprises a first arm dimensioned toengage the groove of the inner rod; a second arm dimensioned to engagethe groove of the outer tube; an outer casing moveable between a distalaxial position where the first and second arms can laterally deflect,and a proximal axial position where the first and second arms areconstrained from laterally deflecting; and a spring biasing the outercasing to the proximal axial position.

The first and second arms may have a snap fit with the grooves on theinner rod and outer tube, respectively. The first and second arms mayeach be cantilevered and each comprise a medial tooth dimensioned tomate with the grooves on the inner rod and outer tube, respectively. Thesurgical device may further comprise a loader dimensioned for receivingend effector. The loader may comprise a locked state where the endeffector is locked in the loader and the end effector outer casing is inits distal axial position, and an unlocked state where the end effectoris unlocked from the loader and the end effector outer casing is in itsproximal axial position. The surgical device may further comprise asecond inner laterally deflecting arm dimensioned to engage the grooveof the inner rod.

In yet another embodiment, a surgical device comprises an elongate shaftcomprising an outer tube and an inner rod positioned in the outer tube,the outer tube and inner rod each comprising a distal end and a proximalend. An actuator is operably connected to the proximal ends of the outertube and the inner rod. An end effector is adapted for in vivoattachment to and detachment from the distal ends of the outer tube andthe inner rod, the end effector comprising a collet for lockingengagement with the distal end of the inner rod. The end effector mayfurther comprise a second collet for locking engagement with the outertube. The surgical device may further comprise a loader comprising acollet for locking the end effector in the loader.

In another embodiment, a loader for facilitating in vivo attachment anddetachment of an end effector to an instrument shaft comprises anelongate shaft having a distal end and a proximal end. A loader tube isconnected to the distal end of the elongate shaft, the loader tubecomprising a distal opening. A collet is positioned in the loader tube,the collet being adapted and sized to receive and engage the endeffector inserted through the distal opening. The collet has a lockedposition relative the loader tube and an unlocked position relative theloader tube. An actuator is connected to the proximal end of theelongate shaft and is operative to select between the locked andunlocked positions.

The loader may further comprise a spring positioned in the loader tubebiasing the collet to the unlocked position. A surgical system maycomprise the loader; a instrument shaft adapted for direct percutaneousinsertion; and an end effector adapted for in vivo attachment to anddetachment from the instrument shaft. The end effector may be adapted toengage the instrument shaft in a locked state and an unlocked state.When the collet receives and engages the end effector in the lockedposition, the end effector may be in the unlocked state; and when thecollet receives and engages the end effector in the unlocked position,the end effector may be in the locked state. The collet may beoperatively connected to the end effector to switch the end effectorbetween the locked and unlocked states. The loader tube may articulaterelative the elongate shaft. The collet in the loader tube may comprisea plurality of cantilevered arms with medially oriented teeth. The teethmay be adapted and sized to engage a circumferential groove in the endeffector.

In still another embodiment, a loader for facilitating in vivoattachment and detachment of an end effector to an instrument shaftcomprises an elongate shaft having a distal end and a proximal end. Aloader tube comprises a proximal end connected to the distal end of theelongate shaft and a distal opening. The loader comprises a means forlocking and unlocking the end effector in the loader tube. An actuatoris connected to the proximal end of the elongate shaft, the actuatorbeing operatively connected to the means for locking and unlocking.

In another embodiment, a loader for facilitating in vivo attachment anddetachment of an end effector to an instrument shaft comprises anelongate shaft having a distal end and a proximal end. A loader tube isconnected to the distal end of the elongate shaft. The loader tubecomprises a distal opening and a collet positioned in the loader tube.The collet being adapted and sized to receive and engage the endeffector inserted through the distal opening. The collet having a firstposition locking the end effector in the loader tube and a secondposition in which the end effector can be withdrawn from the loadertube.

BRIEF DESCRIPTION OF DRAWINGS

While the specification concludes with claims which particularly pointout and distinctly claim the invention, it is believed the inventionwill be better understood from the following description taken inconjunction with the accompanying drawings illustrating somenon-limiting examples of the invention. Unless otherwise indicated, thefigures are not necessarily drawn to scale, but rather to illustrate theprinciples of the invention.

FIG. 1 depicts a surgical instrument with end effector, control shaft,and loader;

FIG. 2 depicts a perspective view on an end effector;

FIG. 3 depicts side and cross-sectional views of an end effector;

FIG. 4 depicts an exploded view of an end effector;

FIG. 5 depicts an exploded view of a loader shaft;

FIG. 6A depicts an cross-sectional view of a loader tube in its lockedposition;

FIG. 6B depicts an cross-sectional view of a loader tube in its unlockedposition;

FIG. 7 depicts an cross-sectional view of a loader tube and an endeffector;

FIG. 8. depicts an cross-sectional view of an end effector locked in aloader tube;

FIG. 9. depicts an cross-sectional view of an end effector locked in aloader tube and a control shaft;

FIG. 10 depicts an cross-sectional view of an end effector locked in aloader tube and a control shaft provisionally attached to the endeffector; and

FIG. 11 depicts an cross-sectional view of an end effector locked onto acontrol shaft and separated from a loader.

DETAILED DESCRIPTION

FIG. 1 illustrates one example of a surgical system. A instrument shaft(300) may comprise an elongate shaft (320) having a distal end (301) anda proximal end (302). The elongate shaft (320) may be rigid and adaptedfor insertion into a body cavity through an access device, such atrocar, or through direct percutaneous insertion without an accessdevice. The elongate shaft (320) may comprise two or more coaxiallynested shafts that move relative one another in response to inputs fromthe actuator (310).

The actuator (310) is operably connected to the proximal end (302) ofthe shaft (320). In this embodiment the actuator (310) is a manualpistol grip handle; however, a variety of other manual actuators couldalso be used, including a scissor grip handle, a syringe grip handle,endoscopic rotary knobs, and the like. The actuator (310) could alsotake the form of a robotic interface, such as an DAVINCI puck, a housingcomprising gears or pulleys, servomechanisms, and the like.

The end effector (100) is adapted for in vivo attachment to anddetachment from the elongate shaft (320). The attachment/detachmentmechanism includes mating features (330) that engage correspondingcollet features in the end effector (100). Relative movement of thecoaxially nested shafts actuate the end effector (100).

The end effector (100) in this embodiment includes a pair of surgicaljaws (110) having an opened position and closed position. In thisembodiment, the jaws (110) are shown as a grasper; however, a variety ofother tissue manipulating jaws could also be used, including dissectors,sheers, babcocks, forceps, staplers, clip appliers, and the like.Non-jawed end effectors (100) could also be employed such as hookknives, snares, retractors, and the like. In the case of end effectorsthat require energy, appropriate energy transmission mechanisms known inthe art may be added. For instance, appropriate electrical connectionsmay be added between the shaft (320) and end effector (100) to enablebi-polar forceps. Similarly, an ultrasonic transducer and waveguide maybe added for the ultrasonic shears end effector.

A loader (200) may be used to introduce the end effector (100) into apatient's body cavity, typically through an access port, and tofacilitate its attachment and detachment of the end effector (100) tothe elongate shaft (320). The loader tube (240) receives the endeffector (100) through its distal end (201). The loader (200) maycomprise an actuator (210), an elongate shaft (220), and loader tube(240). In this embodiment the actuator (210) is a manual pistol griphandle; however, a variety of other manual actuators could also be used,including a scissor grip handle, a syringe grip handle, endoscopicrotary knobs, and the like. The actuator (210) could also take the formof a robotic interface, such as an DAVINCI puck, a housing comprisinggears or pulleys, servomechanisms, and the like. The actuator (210) isoperable to articulate the loader tube (240) relative the shaft (220)about the joint (205), as well as to lock and unlock the loader tube(240).

FIGS. 2-4 illustrate one embodiment of an end effector (100). The endeffector (100) comprises a pair of jaws (110A, B) that pivot relativethe clevis (111). The driver (114) is connected to the jaws (110A, B) bylinks (112), so axial motion of the driver (114) relative the clevis(111) will cause the jaws (110A, B) to move between their open andclosed positions. The clevis (111) and the tube (124) are both axiallyfixed to the inner casing (128) as an inner sub-assembly.

The outer casing (132) is generally tubular in shape and comprises acircumferential groove (134). The pin (120) axially fixes the collar(122) to the outer casing (132) as an outer sub-assembly. The inner andouter sub-assemblies are coaxially nested relative one another. The pin(120) travels in the slot (130) thus facilitating axial movement of theouter sub-assembly between a distal position and a proximal positionrelative the inner sub-assembly. As shown in FIGS. 2 and 3, the outersub-assembly is in its proximal position. The slot (130) may define theaxial stroke limit of the outer sub-assembly. The spring (118) isinterposed between the clevis (111) and the collar (122) and biases theouter sub-assembly to its proximal position.

The driver (114) and tube (124) each comprise a collet mechanism toselectively engage and hold the corresponding mating features (330) onthe elongate shaft (320). In this embodiment, the driver (114) comprisesa pair of cantilevered arms (116) each having a medially oriented cleator tooth on the proximal end. The tube (124) comprises a cantileveredarm (126) with a medially oriented cleat or tooth. The number andconfiguration of the arms (116, 126) may vary. When the outersub-assembly is in its distal position, the arms (116) may resilientlydeflect laterally. Similarly, the arm (126) may resiliently deflectlaterally. When the outer sub-assembly is in its proximal position, thecollar (122) circumscribes and constrains the arms (116) to their medialposition and prevents them from lateral deflecting. Similarly, the outercasing (132) circumscribes and constrains the arm (126) to its medialposition and prevents it from lateral deflecting. When the outersub-assembly is in its distal position, the end effector (100) may beconsidered in its the unlocked position, and when outer sub-assembly isin its proximal position the end effector (100) may be considered in itslocked position.

FIGS. 5-6 illustrate one embodiment of a loader (200). In thisembodiment, the shaft (220) comprises a plurality of co-axially arrangedrods, including an outer tube (222), an inner tube (226), and an innerrod (228) each operably connected to the actuator (210). The inner tube(226) is axially fixed to the proximal hinge component (232). The outerhousing (246) is axially fixed to the distal hinge component (242). Theproximal hinge component (232) is connected to the distal hingecomponent (242) by the pin (234) as the axis of the hinge articulation.Outer tube (222) comprises a distal extension (224) connected to theouter housing (246), so axial movement of the outer tube (222) relativeto the inner tube (226) will cause the loader tube (240) to articulate.

The loader tube (240) comprises a collet mechanism to selectively engageand hold the end effector (100). In this embodiment an inner lockingtube (248) and outer locking tube (250) are axially fixed to one anotheras a locking sub-assembly. The locking sub-assembly is coaxially nestedwithin outer housing (246) and can slide axially between a distalposition and a proximal position. The spring (244) is interposed betweenthe distal hinge component (242) and the locking sub-assembly, andbiases the locking sub-assembly to its distal position. The flexibleextension (230) of the inner rod (228) is slideably positioned throughthe hinge components (232, 242) and is axially fixed to the lockingsub-assembly. Pulling the inner rod (228) proximally relative the innertube (226) will similarly pull the locking sub-assembly proximally andcompress the spring (244).

The outer locking tube (250) comprises a plurality of arms (252) with amedially oriented cleats or teeth. The number and configuration of thearms (252) may vary. When the locking sub-assembly is in its proximalposition, the arms (252) may resiliently deflect laterally. Optionally,the arms (252) may be biased laterally outward. When the lockingsub-assembly is in its distal position, the outer housing (246)circumscribes and constrains the arms (252) to their medial position andprevents them from deflecting laterally. When the locking sub-assemblyis in its proximal position, the loader tube (240) may be considered inits the unlocked position, and when locking sub-assembly is in itsdistal position the loader tube (240) may be considered in its lockedposition.

FIGS. 7-11 illustrate a sequence of the instrument being introduced foruse in the surgical field. FIG. 7 illustrates the loader tube (240) inits unlocked position ready to receive the end effector (100). The endeffector (100) may be slid into the loader tube (240) until the cleatsor teeth of the arms (252) align with the circumferential groove (134).

As shown in FIG. 8, when the locking sub-assembly is pulled proximallyso the loader tube (240) is in its locked position, the cleats or teethof the arms (252) engage the circumferential groove (134) and lock theend effector into the loader tube (240). Simultaneously, the cleats orteeth of the arms (252) will pull the outer casing (132) distally so theend effector (100) is in its unlocked position. Accordingly, the arms(116, 126) are able to deflect laterally. This configuration is wellsuited to introduce the end effector (100) into the patient body cavity,typically through an access device in a non-articulated position.

As shown in FIG. 9, the distal end (301) of the elongate shaft (320) canbe introduced into the patient body cavity, either through an accessdevice or through direct percutaneous insertion. For direct percutaneousinsertion uses, the elongate shaft (320) may be less than about 3 mm indiameter. In this embodiment the elongate shaft (320) comprises only tworods: an outer tube (322) and an inner rod (321). The outer tube (322)and an inner rod (321) are coaxially nested and can slide relative oneanother in response to inputs to the actuator (310). The outer tube(322) comprises a circumferential groove (332) dimensioned to receivethe cleat or tooth of the arm (126). The inner rod (321) comprises acircumferential groove (331) dimensioned to receive the cleats or teethof the arms (116). Optionally, the distal tip of the inner rod (321) maybe pointed to facilitate direct percutaneous insertion.

As shown in FIG. 10, the distal end (301) of the elongate shaft (320)can be inserted into the end effector (100) till the cleats or teeth ofthe arms (116, 126) resiliently deflect laterally and then snap into thegrooves (331, 332), respectively. In this configuration, the endeffector (100) is provisionally attached to, but not locked onto, theelongate shaft (320).

As shown in FIG. 11, loader tube (240) can be moved to its unlockedposition in response to inputs from the actuator so the arms (252)disengage from the groove (134), thus allowing the end effector (100) tobe withdrawn from the loader tube (240). Simultaneously, the springloaded outer housing (132) will bias proximally, thus locking the endeffector (100) onto the distal end (301) of the elongate shaft (320).Through operation of the actuator (310), the inner rod (321) may be slidaxially relative the outer tube (322), which will in turn slide thedriver (114) relative the clevis (111) to open and close the jaws (110)so tissue may be manipulated during surgical procedures. The instrumentcan then be removed from the surgical field by reversing the sequence ofFIGS. 7-11.

Having shown and described various embodiments and examples of thepresent invention, further adaptations of the methods and devicesdescribed herein can be accomplished by appropriate modifications by oneof ordinary skill in the art without departing from the scope of thepresent invention. Several of such potential modifications have beenmentioned, and others will be apparent to those skilled in the art. Forinstance, the specific materials, dimensions, and the scale of drawingswill be understood to be non-limiting examples. Accordingly, the scopeof the present invention should be considered in terms of the followingclaims and is understood not to be limited to the details of structure,materials, or acts shown and described in the specification anddrawings.

1. A surgical device, comprising: a) an elongate shaft comprising adistal end and a proximal end; b) an actuator operably connected to theproximal end of the elongate shaft; c) an end effector adapted forattachment to and detachment from the distal end of the elongate shaft,the end effector comprising: i) a laterally deflecting arm dimensionedto engage at least a portion of the distal end of the elongate shaft;and ii) a ring comprising a first axial position and a second axialposition, wherein in the first position the arm can deflect laterallyand in the second position the ring circumscribes the arm and constrainsthe arm from deflecting laterally.
 2. The surgical device of claim 1,wherein the distal end of the inner rod comprises a pointed tip.
 3. Thesurgical device of claim 1, wherein the actuator comprises a manualhandle.
 4. The surgical device of claim 1, wherein the end effector isadapted for in vivo attachment and detachment from the distal end of theelongate shaft.
 5. The surgical device of claim 1, wherein the elongateshaft is adapted for direct percutaneous insertion.
 6. The surgicaldevice of claim 1, further comprising a spring in the end effector, thespring biasing the ring to the second position.
 7. The surgical deviceof claim 6, wherein the ring first position is distal of the ring secondposition.
 8. The surgical device of claim 1, further comprising a loaderdimensioned for receiving end effector, the loader comprising: a lockedstate where the end effector is locked in the loader and the endeffector ring is in its first position; an unlocked state where the endeffector is unlocked from the loader and the end effector ring is in itssecond position.
 9. The surgical device of claim 1, wherein the armcomprises a medial tooth that engages a groove in the distal end of theelongate shaft.
 10. A surgical device, comprising: a) an elongate shaftcomprising an outer tube and an inner rod positioned in the outer tube,the outer tube and inner rod each comprising a distal end and a proximalend, the inner rod and outer tube each comprising a groove on the distalend; b) an actuator operably connected to the proximal ends of the outertube and the inner rod; c) an end effector adapted for in vivoattachment to and detachment from the distal ends of the outer tube andthe inner rod, the end effector comprising: i) a first arm dimensionedto engage the groove of the inner rod; ii) a second arm dimensioned toengage the groove of the outer tube; iii) an outer casing moveablebetween a distal axial position where the first and second arms canlaterally deflect, and a proximal axial position where the first andsecond arms are constrained from laterally deflecting; and iv) a springbiasing the outer casing to the proximal axial position.
 11. Thesurgical device of claim 10, wherein the first and second arms have asnap fit with the grooves on the inner rod and outer tube, respectively.12. The surgical device of claim 10, wherein the first and second armsare each cantilevered and each comprise a medial tooth dimensioned tomate with the grooves on the inner rod and outer tube, respectively. 13.The surgical device of claim 10, further comprising a loader dimensionedfor receiving end effector, the loader comprising: a locked state wherethe end effector is locked in the loader and the end effector outercasing is in its distal axial position; an unlocked state where the endeffector is unlocked from the loader and the end effector outer casingis in its proximal axial position.
 14. The surgical device of claim 10,further comprising a second inner laterally deflecting arm dimensionedto engage the groove of the inner rod.
 15. A surgical device,comprising: an elongate shaft comprising an outer tube and an inner rodpositioned in the outer tube, the outer tube and inner rod eachcomprising a distal end and a proximal end; an actuator operablyconnected to the proximal ends of the outer tube and the inner rod; anend effector adapted for in vivo attachment to and detachment from thedistal ends of the outer tube and the inner rod, the end effectorcomprising a collet for locking engagement with the distal end of theinner rod.
 16. The surgical device of claim 15, the end effector furthercomprising a second collet for locking engagement with the outer tube.17. The surgical device of claim 15, further comprising a loadercomprising a collet for locking the end effector in the loader.